21.3M People Choose ACA Marketplace Coverage

WASHINGTON — More than 21.3 million people selected an Affordable Care Act Health Insurance Marketplace plan during the most recent open enrollment period, including 5 million who were accessing the marketplaces for the very first time, the Biden-Harris administration announced.

A total of 16 million people renewed their coverage during the federal enrollment period that ran from Nov. 1, 2023, to Jan. 16, 2024.

Significantly, when the administration announced its tally, the number of enrollees was still climbing as open enrollment in four states and the District of Columbia, which use a state-based marketplace platform, continues through Jan. 31.

“For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind — Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth — the Affordable Care Act,” said Health and Human Services Secretary Xavier Becerra in a written statement.

“Once again, a record-breaking number of Americans have signed up for affordable health care coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage,” he continued, adding “The ACA continues to be a successful, popular and important federal program to millions of people and their families.”

The administration attributed the large number of enrollees to its continued commitment to making health insurance available and affordable to everyone, with a big assist from the passage of the Inflation Reduction Act and the American Rescue Plan.

Thanks to the IRA, HHS said in a press release, four in five HealthCare.gov customers were able to find health care coverage for $10 or less per month after subsidies for plan year 2024.

Additionally, the administration issued almost $100 million in Navigator Awards, allowing organizations to hire staff trained to help consumers find affordable, comprehensive health coverage.

Navigators, as they are known, have been key to helping consumers in every Marketplace state, the White House said.

These steps expanded access to affordable, comprehensive Marketplace coverage for millions of middle- and lower-income families nationwide.

Compared to the open enrollment period last year, nearly 4.2 million more individuals with household incomes less than 250% of the federal poverty level (about $75,000 per year for a family of four) enrolled in 2024 coverage.

Administration officials said this demonstrates that when coverage is affordable, people sign up.

Marketplace coverage has also been critical for many people transitioning from Medicaid or the Children’s Health Insurance Program as states conduct eligibility renewals, which restarted last year, the HHS said.

As of Dec. 31, Centers for Medicare & Medicaid Services data show that 2.4 million plan selections in states that use HealthCare.gov, or approximately 15%, were made by individuals who were previously enrolled in Medicaid or CHIP coverage.

HHS said the public should be aware that coverage opportunities remain available even now, after the annual open enrollment period has ended.

Individuals eligible for Medicaid or CHIP may enroll in coverage anytime year-round. For those no longer eligible for Medicaid or CHIP, a special enrollment period is available to enroll in Marketplace coverage.

Additionally, eligible individuals with household incomes less than 150% of the federal poverty level (approximately $22,000/year for an individual and $45,000/year for families of four) can enroll in Marketplace coverage anytime through a special enrollment period.

Consumers who experience a change of life circumstance — such as marriage, birth, adoption, or loss of qualifying health coverage — may also be eligible for a special enrollment period.

Administration officials encouraged consumers to visit HealthCare.gov to see if they are eligible to enroll in a low-cost, quality health plan. Because of continuing provisions in the Inflation Reduction Act, CMS expects nine out of 10 customers to be eligible for savings.

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